Operations, Trauma

EMS Providers Should be Wary of the Tools They Use

Issue 4 and Volume 37.

As I’ve said many times in this column, some of the best tools in the history of this important business of ours were never intended or designed to be used like we use them.

My dad was a construction man, and that notion would have driven him nuts. “Use a tool for its intended purpose,” he would bellow any time I used a screwdriver as a lever, a good Purdy paint brush to remove dust from a sanded surface or a fine, old Irwin wood chisel to scrape paint off a window. I now know why he felt so strongly about his hand tools, having bought and cared for implements of my own. When something earns you a living, you respect it.

But unlike EMS, the construction business mandates you have precisely the right tools. When you need to bore a 1–3/16″ hole through 3-1/2″ of old fir, you need a sharp, straight, self-feeding auger and a 1/2″ drill motor. That’s it. Use the wrong tools (or dull ones) and you’ll waste time, screw up a job or risk an injury that could put you out of work. Use cheap tools and you’ll end up buying them over and over. So you buy good ones, maintain them and keep them organized.

When your tools don’t fit in your toolbox, you buy a bigger toolbox. When a box gets too big, you carry your tools (and smaller boxes) in the compartments of a truck. And when you outgrow the truck, you resort to a trailer—or a bigger truck. If that’s too small, you bring a portable shed to the site. (Or you build one.)

EMS is nothing like construction, Life-Saver. For us, everything must be portable. That means not too big and not too heavy. You can’t carry it all, so you improvise. Ever notice how, in your first couple of years, you burdened yourself with every gadget you could find? An expensive penlight, maybe (which got lost), or a Leatherman tool. A nice pen. Hemostats. Trauma shears and maybe a $200 stethoscope, which got borrowed and never returned.

Then, as you gained experience, chances are you relied on your brain more and your tools less. You learned to use an oxygen cannula and an IV setup to irrigate someone’s eyes. You learned to twist a sheet into a girth hitch for the ankles of a patient who needs to be slid lengthwise. Or stabilize someone’s head with a pair of blanket rolls and some one-inch Transpore tape. Ambulances don’t come with trailer hitches. So you just sort of find a way.

It’s a dirty world out there. In this column, I’ve often discussed leaving your boots at work, cleaning your steering wheel and door handles and sanitizing your cot. But there’s a tool you use more often than anything else, and that’s your watch.

Think about it. You handle your watch a lot. You wear it when you examine people you don’t know, and you wear it when you take a leak. Then, you remove it while you scrub your hands. (Where do you put it while you’re doing that, eh?) And finally, you put it back on again. If anybody ever told you what kinds of cooties were growing on that thing, you’d probably have a seizure.

I’ve rarely seen anyone cleaning their watch. Have you? Hmm, maybe it’s worth some attention. No matter how often you consult it, you wear it when you eat, and you wear it home.

I don’t know if your experience is anything like mine, but I’m a Windex fan. I use Windex to clean just about everything, and I learned that from ambulance windshields. Cleaning the inside of a windshield isn’t something you want to do even once more in your life than you have to. If I use real Windex, use clean paper towels (or newspaper) and wipe the thing dry when I’m done, I know I won’t have to do it over. Now, I’m no genius. But I know that if it’s clean enough to see through (that means no streaks, even at night), then it’s clean.

Life ain’t easy, for a trained observer. You know that schmutz you see sometimes, in the little hidden areas of your watchband? Well, I’ve been using Windex and old toothbrushes to clean my watches for years. I still have very good vision, and I notice a lot that goes on around me. But I just don’t see that stuff anymore.
Not on my watch.This article originally appeared in April 2012 JEMS as “Not On Your Watch: Choosing the right tool for the job.”